General Session 1: Management of Early Stage Esophageal Cancer
Naohisa Yahagi, MD, PhD
Keio University School of Medicine
Endoscopic Management As Definitive Therapy
Conclusion:
- Endoscopic management of Barrett's cancer is minimally invasive and very effective.
- Targe lesion of endoscopic treatment is T1a and a part of T1b.
- Complete eradication of LSBE is desirable.
- ESD is more reliable than EMR + RFA
Christopher Morse, MD
Massachusetts General Hospital
The Role and Need for Surgical Resection
Conclusion:
Surgery continues to have a role in early-stage esophageal cancer
- High-risk T1b lesions - Opportunity for lymph node metastasis increased
- LVI/Poor differentiation/Increased depth of invasion
Surgery best accomplished by high volume surgeons at high volume centers
Minimally invasive esophagectomy appears to improve perioperative outcomes
T2N0 - Accurate staging remains a challenge; High-risk lesions identified?/No apparent survival advantage
Michael G. Haddock, MD
Mayo Clinic
Chemoradiation for Early Stage Disease
Conclusion:
Definitive chemoradiation may be an appropriate option for T1bN0M0 esophageal cancer patients who decline surgery
Data is mostly in SQC histology and Asian patients
Daniela Molena, MD
Memorial Sloan Kettering Cancer Center
Current and Upcoming Clinical Trials
Reported two trials:
Study Title: Peri-operative Immuno-Chemotherapy in Operable Oesophageal and Gastric Cancer (ICONIC Trial)
ClinicalTrials.gov Identifier: NCT03399071 currently recruiting
Study Title: A Phase II/III Study of Peri-Operative Nivolumab and Ipilimumab in Patients With Locoregional Esophageal and Gastroesophageal Junction Adenocarcinoma
ClinicalTrials.gov Identifier: NCT03604991 not yet recruiting